Immunity, inflammation and disease · 2026
Early Mortality Following Systemic Anticancer Therapy in Lung Cancer: A Bayesian Spatiotemporal Multilevel Analysis.
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Tesema Getayeneh Antehunegn, Stirling Rob G, Wah Win, Tessema Zemenu Tadesse, Heritier Stephane, Earnest Arul
Аннотация
INTRODUCTION: Despite advances in lung cancer treatment, early mortality following Systemic Anticancer Therapy (SACT) remains a major concern. Identifying patients at high risk of early mortality may inform treatment decision-making, particularly where SACT may offer limited benefit. We aimed to quantify spatiotemporal patterns of early mortality following SACT and to examine the relative contributions of individual- and area-level risk factors.
METHODS: We conducted a secondary analysis of data from the Victorian Lung Cancer Registry. Bayesian spatiotemporal multilevel models were used to assess associations between individual- and area-level factors and early mortality following SACT. Adjusted Odds Ratios (AORs) with 95% Credible Interval (Crl) were reported to indicate statistical significance.
RESULTS: Substantial spatiotemporal variation in early mortality following SACT was observed across Victoria. Factors associated with increased odds of early mortality included age ≥ 60 years (AOR = 1.06, 95% Crl: 1.01-1.22), clinical stage II (AOR = 1.15, 95% Crl: 1.01-1.59), stage III (AOR = 1.28, 95% Crl: 1.01-2.05), stage IV (AOR = 3.19, 95% Crl: 2.12-5.07), comorbidity (AOR = 1.12, 95% Crl: 1.01-1.34), and poor performance status (AOR = 3.09, 95% Crl: 2.24-4.24). Presentation at a multidisciplinary meeting (AOR = 0.66, 95% Crl: 0.52-0.88) and receipt of supportive care screening (AOR = 0.53, 95% Crl: 0.41-0.69) were associated with reduced odds of early mortality.
CONCLUSION: Marked spatiotemporal variation in early mortality following SACT highlights the need for targeted, risk-informed treatment strategies, particularly for patients with advanced disease, comorbidities, poor performance status, and those residing in high-risk areas.
METHODS: We conducted a secondary analysis of data from the Victorian Lung Cancer Registry. Bayesian spatiotemporal multilevel models were used to assess associations between individual- and area-level factors and early mortality following SACT. Adjusted Odds Ratios (AORs) with 95% Credible Interval (Crl) were reported to indicate statistical significance.
RESULTS: Substantial spatiotemporal variation in early mortality following SACT was observed across Victoria. Factors associated with increased odds of early mortality included age ≥ 60 years (AOR = 1.06, 95% Crl: 1.01-1.22), clinical stage II (AOR = 1.15, 95% Crl: 1.01-1.59), stage III (AOR = 1.28, 95% Crl: 1.01-2.05), stage IV (AOR = 3.19, 95% Crl: 2.12-5.07), comorbidity (AOR = 1.12, 95% Crl: 1.01-1.34), and poor performance status (AOR = 3.09, 95% Crl: 2.24-4.24). Presentation at a multidisciplinary meeting (AOR = 0.66, 95% Crl: 0.52-0.88) and receipt of supportive care screening (AOR = 0.53, 95% Crl: 0.41-0.69) were associated with reduced odds of early mortality.
CONCLUSION: Marked spatiotemporal variation in early mortality following SACT highlights the need for targeted, risk-informed treatment strategies, particularly for patients with advanced disease, comorbidities, poor performance status, and those residing in high-risk areas.